Individual provider Active NPI

Isaac Adeyemi, NP

  • Family Nurse Practitioner
  • Richton Park, IL
National Provider Identifier
1427622232
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209023262 Issued in IL
Practice address
22858 Millard Ave
Richton Park, IL 60471-2531
Phone
(773) 759-1297
NPI assigned
May 17, 2021
Last updated
May 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 209023262 IL Primary

Addresses

Primary practice location

22858 Millard Ave
Richton Park, IL 60471-2531

Mailing address

22858 Millard Ave
Richton Park, IL 60471-2531
Phone (773) 759-1297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209023262ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Home Healthcare Inc CurrentSince May 25, 2021 Accepting new patients
Light of Hope PastSince May 25, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1427622232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22858 MILLARD AVE",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604712531",
            "telephone_number": "773-759-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22858 MILLARD AVE",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604712531",
            "telephone_number": "773-759-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEYEMI",
        "first_name": "ISAAC",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richton Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.